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[letterhead stationery or return address]|
[Name and address of addressee]
[Optional beginning sentence: This letter will confirm our recent telephone conversation.] I am completing a doctoral dissertation at __________ University entitled "__________." I would like your permission to reprint in my dissertation excerpts from the following:
[Insert full citation and description of the original work.]The requested permission extends to any future revisions and editions of my dissertation, including non-exclusive world rights in all languages, and to the prospective publication of my dissertation by UMI. These rights will in no way restrict republication of the material in any other form by you or by others authorized by you. Your signing of this letter will also confirm that you own [or your company owns] the copyright to the above-described material.
If these arrangements meet with your approval, please sign this letter where indicated below and return it to me in the enclosed return envelope. Thank you very much.
[Your name and signature]
PERMISSION GRANTED FOR THE
|PERMISSION GRANTED FOR THE|
USE REQUESTED ABOVE:
[Type name of company]